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Bicornuate Uterus and the Termination of Pregnancy

Bicornuate Uterus and the Termination of Pregnancy

During the termination of a pregnancy, a bicornuate uterus can present certain problems, as it may fail if the correct type of procedure is not performed. That is why it is important for medical professionals to pay close attention to women with uterine abnormalities, for it is likely such a condition will determine the type of treatment provided.

What is a Bicornuate Uterus?

A bicornuate uterus is type of congenital uterine abnormality whereby the uterus does not form as it should. Rather than a whole, pear-shaped womb, a bicornuate uterus has a heart-shaped appearance. This happens because there is a large indentation at the top of the uterus, causing the fallopian tubes to look like two horns.

A bicornuate uterus can pose a number of problems during pregnancy, particularly if the fertilised egg becomes implanted into one of the fallopian tubes. This is because the tissue in this part of the womb is not strong enough or large enough for the foetus to develop. Consequently, a woman with a bicornuate uterus faces a higher risk of miscarriage. Furthermore, there is a greater chance of breech birth, premature birth and a retained placenta.

Terminating a Pregnancy with a Bicornuate Uterus

Should a woman with a bicornuate uterus wish to terminate the pregnancy, medical professionals must take note of her condition, as it will affect which type of procedure is performed.

Indeed, a woman with a normal uterus may opt for either a medical or a surgical procedure. Medical termination sees the patient take two types of medication over a period of 48 hours, while a surgical termination is an operation carried out under general anaesthetic. The type of procedure performed will often be determined by the length of pregnancy, the patient's preference and the services available.

However, a woman with a bicornuate uterus should be advised to have a medical termination, as it is likely that a surgical termination will not be successful.

Does a Failed Termination Amount to Medical Negligence?

If you have a bicornuate uterus and you have undergone a termination that had failed, you will understandably be feeling angry and upset. You may also be wondering whether or not the medical treatment you received fell below an acceptable standard, thereby amounting to medical negligence. Unfortunately there is no simple answer, as each case will differ. However, there are certain circumstances in which you could make a medical negligence claim.

Firstly, if you are aware that you have a bicornuate uterus, medical professionals should take note of this fact before arranging a termination procedure. Your medical records should be revised, while you should also be asked if you have any abnormalities in a pre-operative assessment. If there is a failure to do so, your condition could either be missed or ignored, and the termination could fail. Should you remain pregnant, you will have to go through the upsetting ordeal of having a second termination procedure, or you may even be left with little choice but to continue with the pregnancy. In such an event, you may well be entitled to make a claim.

On the other hand, if a woman is unaware she has a uterine abnormality, medical professionals may not be at fault for deciding upon a surgical termination. Transvaginal ultrasounds are not yet commonplace before termination procedures, and thus diagnosing an abnormality if often only possible once the termination is found to be unsuccessful. Nevertheless, measures should be taken to ensure a woman is no longer pregnant after a termination, particularly if there is some doubt. This may include an examination, a pregnancy test as well as an ultrasound scan.

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